Epilepsy: causes, symptoms and treatment methods

Every year, about 5 million new cases of epilepsy are diagnosed worldwide, according to the World Health Organization. If you do the math, that means that every 10 minutes, someone in the world experiences a first-time seizure. That means that as you read this, somewhere on the planet, someone is experiencing an event that could change their life forever.

Epilepsy is not uncommon. According to the World Health Organization, about 50 million people worldwide live with this disease. More than 2.4 million new cases are registered every year. In Ukraine, according to official statistics of the Ministry of Health, the number of patients with this diagnosis is approximately 100 thousand people.

But even with its prevalence, there are still many myths, fears, and stigmas surrounding epilepsy. Most people don’t know what epilepsy is, how to appropriately respond if someone close to them is having a seizure, and providing the wrong help can be harmful.

Olha Novikova

manager of Epiprosvita

• civic activist
• volunteer
• mother of a child with a disability

What do you need to know about epilepsy? How to help a person during an attack — and what absolutely cannot be done? The MEDPLUS editorial team asked Olga Novikova, manager of the NGO “Epiprosvita”, a public activist, volunteer, and mother of a child with a disability. The following is a direct speech.

– What is epilepsy, and how does it occur?

– Imagine that your brain is a computer with many wires transmitting signals. These signals help us think, move, speak, see, and hear. But sometimes these signals “go off course”—and instead of a precise, orderly movement, they start to “fire” chaotically. This is epilepsy. When unexpected and powerful electrical signals arise in the brain.

These “flashes” can cause seizures. In some people, they can have convulsions, when the body shakes and the person does not respond. In others, it can be just a brief “freeze,” when the person stares at one point and does not respond for a few seconds. Seizures can vary greatly.

– Why does epilepsy occur?

– There can be many reasons for the development of epilepsy:

• Some people have a brain that works this way from birth, this is called a genetic form — then we talk about idiopathic epilepsy.
• Some people have epilepsy after a head injury, stroke, tumor, or brain infection. This is symptomatic epilepsy.
• Sometimes doctors can’t even find the exact cause — then they say that epilepsy has an “unspecified” origin and call it “cryptogenic epilepsy”

– Can epilepsy develop in an adult who was previously completely healthy?

– Yes, it can. For example, after a head injury, stroke, tumor, brain infection, or due to age-related changes. In addition, some genetic diseases can “manifest”—that is, become apparent — for the first time in adulthood, even if the person did not have symptoms in childhood.

– Is it true that a person can “swallow their tongue” during an epileptic seizure?

– No, it’s not true. However, during a seizure, the tongue can move back and block breathing, or the person can bite their tongue, which looks scary, but it doesn’t mean that the tongue has been “swallowed.” The best thing to do in such a situation is to carefully lay the person on their side so that they can breathe freely and don’t choke on anything.

– Is it safe to touch someone during an epileptic seizure?

– Yes, touching someone during an epileptic seizure is safe and even necessary if it helps protect them from injury. For example, you should put something soft under their head, move furniture away so they don’t hit themselves, and gently turn them onto their side if possible. But you should not hold a person by force or put something in the mouth—it can only harm. The most important thing is to stay close and wait for the seizure to pass.

– Is epilepsy a psychological condition?

– No, epilepsy is not a mental illness but a neurological disease—that is, it is related to the functioning of the brain and the electrical signals in it. People with epilepsy can have good memories, emotions, and intelligence, like everyone else. However, due to frequent seizures or the stigma surrounding the condition, some people may experience emotional difficulties, such as anxiety or depression, and this requires support but does not mean that epilepsy is a mental disorder.

– Can epilepsy be cured permanently?

– In some people, epilepsy can indeed be cured permanently, primarily if the cause is known, for example, a tumor or scar in the brain that can be removed surgically. In other cases, epilepsy can be well controlled with medication, and people can go years without having seizures. However, some forms are difficult to treat, and the question is not about a complete cure but reducing the frequency and severity of these attacks. In any case, the proper treatment gives you a chance to live a whole life.

– Does epilepsy always cause seizures?

– They can look completely different—for example, a person “falls out” of reality for a few seconds, freezes, stops responding, or stares at one point. Such attacks are called absence seizures. Sometimes epilepsy manifests itself only with strange sensations, smells, trembling in a part of the body, or sharp emotions. So a seizure is not always a big convulsion, as we imagine from the movies.

– What “non-obvious” symptoms can be a sign of epilepsy?

– Epilepsy can manifest itself not only with seizures, but also with “non-obvious” symptoms that are easy to confuse with something else:

• brief “blackouts” of consciousness;
• strange smells, sounds, or tastes that are not really there;
• automatic movements (lip smacking, picking at objects);
• feeling cold, hot, or afraid for no reason;
• temporary loss of speech or memory.

– How to understand that a child or an adult has had an epileptic seizure?

– There are several signs that a child or an adult has had an epileptic seizure. A person may suddenly fall, have convulsions—the body tenses or shakes a lot, it does not respond to appeals, foaming at the mouth or urinary incontinence may appear. But not all seizures look like this. Sometimes a person simply “turns off” for a few seconds, looks at one point, does not respond, makes strange movements (fingers, chews, walks aimlessly), or looks confused. After a seizure, a person often looks tired, sleepy, and may not remember anything. If these symptoms recur or the person seems suspicious, you should see a doctor.

– What to do if you witness an epileptic seizure?

– If you see someone having an epileptic seizure, the main thing is to act calmly and attentively. Do not panic, and first of all, look at the clock or turn on the timer to know how long the seizure lasts — this is very important for doctors. If possible, record a video — this will help to diagnose the type of seizure correctly.

Ensure there are no dangerous objects nearby, and if the person has fallen, put something soft under their head and carefully turn them on their side. Do not hold the person or try to put anything in their mouth — this can be harmful. After the seizure, stay nearby, speak calmly, explain what happened, and help them recover. If the seizure lasts longer than 5 minutes or the person is injured, call an ambulance.

– What should not be done during an epileptic seizure — and why?

• Do not hold the person by force — it will not help, but only injure.
• Do not put anything in the mouth — it is dangerous, the person may choke.
• Do not give water or medicine — you may choke.
• Do not scare, do not shout — after the seizure, the person is disoriented.

These actions can harm — it is better just to be nearby.

– When should you call an ambulance for epilepsy?

– An ambulance should be called for epilepsy if the seizure lasts more than 5 minutes, or one seizure progresses to the next without regaining consciousness — this is life-threatening. An ambulance should also be called if the person has been injured, is not breathing after the seizure, has their first seizure in their life, or if there are doubts that this is epilepsy. An ambulance should always be called for children, even if the seizure does not last long — this is a safety rule. Furthermore, be sure to call an ambulance if the seizure occurred in a pregnant woman or a person with chronic diseases — they need additional examination.

– How does a person with epilepsy live? Can they drive a car? Go to the pool? Play sports?

– A person with epilepsy can live a full life — study, work, have a family, play sports, dream and achieve goals, just like anyone else. However, there are some safety restrictions.

For example, you can drive a car only when there are no seizures for a specific period (in Ukraine, at least 1 year), which must be confirmed by a doctor. You can go to the pool or swim in open water only under supervision, because a seizure can be dangerous. Playing sports is allowed, but avoiding extreme types, such as rock climbing or jumping from a height, is better.

For many people with epilepsy, physical activity is even useful — it strengthens the body, reduces stress, and improves mood. The main thing is knowing your diagnosis, following treatment, and always thinking about safety.

My daughter, who has severe epilepsy, swims better than I and rides horses, because there are coaches nearby who know about the diagnosis and make these lessons safe.

Remember: epilepsy is not a sentence, but a condition with which you can live fully. The main thing is to know how to act, support those around you, and not be afraid to ask doctors.

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